A question from Pam: I live in Phoenix, AZ and my mother lives with my sister in Cleveland, OH. I visit as often as I can and call to check in on both of them, but most of the time I feel badly that my sister is doing all of the work. What more can I be doing?

Answer: I hear this question so often from the family caregivers I speak with. Even though you can't be physically present, there are many ways to show your support to both your mother and your sister. Here are just a few ideas:

* Time--can you visit for a weekend to give your sister a break? Let her get away and do something for herself.
* Money--can you afford to pay for or contribute to companion care so your sister can have a few hours once a week to herself?
* Bills and finances--can you be in charge of paying the bills and keeping track of the finances? Most of this can be done on-line making it easier to do from a distance.
* Perhaps you can be there for your sister to vent to when she needs it. An understanding ear can be incredibly helpful to the primary caregiver.
* Ask your sister what you can do. If you are not able to do what she requests, first ask yourself why. Is it too emotionally difficult? Is it a financial reason? Then explain to your sister. Have a dialogue trying to put yourself in each other's shoes.
* A simple thank you. Being the primary caregiver is tough and can result in one feeling alone. Just calling or sending notes to say thank you to your sister can mean more than you know.

Keep in mind that caregiving among siblings will rarely be split completely evenly given geographic distance and other variables. What is important is that each person is doing the best he or she is able given his or her particular circumstances. I'd love to hear more ideas you all may have!